Migration and tuberculosis in Europe

Immigrants arriving from high-incidence tuberculosis (TB) countries may pose a threat to TB control in low-incidence European host countries. Besides the immediate morbidity and mortality from any resurgence of TB, there would also be the increased economic cost of treatment of cases, tracing and preventive treatment of contacts, as well as concern over the potential emergence of drug-resistant forms of TB. This study analysed the 28 countries of the European Union, plus Iceland and Norway (EU+2). A Pearson correlation analysis of each country and all countries combined during the years 2011-2017 was conducted in order to detect any potential correlation between the number of immigrants annually and the TB notification rates per 100,000 total population. The overall data showed a significant negative correlation between the number of immigrants and TB rate. A negative correlation was also found for 22 of the 30 EU countries. In three countries (Germany, Italy, and Norway), a significant positive correlation between TB notification rates and immigration numbers was observed. Overall, the study did not show a clear pattern between TB transmission and immigration. Continued surveillance of migration and TB rates is essential, and there is a need for harmonization of case definitions and reporting standards to optimize TB control programs within Europe.